tbuckley/cabot-search huggingface dataset:
Mortality in children under 5 years of age with congenital syphilis in Brazil: A nationwide cohort study
Authors: Enny S. Paixao, Andrêa JF Ferreira, Idália Oliveira dos Santos, Laura C. Rodrigues, Rosemeire Fiaccone, Leonardo Salvi, Guilherme Lopes de Oliveira, José Guilherme Santana, Andrey Moreira Cardoso, Carlos Antônio de S. S. Teles, Maria Auxiliadora Soares, Eliana Amaral, Liam Smeeth, Mauricio L. Barreto, Maria Yury Ichihara
Journal: PLoS Medicine (2023)

Background Congenital syphilis (CS) is a major and avoidable cause of neonatal death worldwide. In this study, we aimed to estimate excess all-cause mortality in children under 5 years with CS compared to those without CS. Methods and findings In this population-based cohort study, we used linked, routinely collected data from Brazil from January 2011 to December 2017. Cox survival models were adjusted for maternal region of residence, maternal age, education, material status, self-declared race and newborn sex, and year of birth and stratified according to maternal treatment status, non-treponemal titers and presence of signs and symptoms at birth. Over 7 years, a total of 20 057 013 live-born children followed up (through linkage) to 5 years of age, 93 525 were registered with CS, and 2 476 died. The all-cause mortality rate in the CS group was 7·84/1 000 person-years compared with 2·92/1 000 person-years in children without CS, crude hazard ratio (HR) = 2·41 (95% CI 2·31 to 2·50). In the fully adjusted model, the highest under-five mortality risk was observed among children with CS from untreated mothers HR = 2·82 (95% CI 2·63 to 3·02), infants with non-treponemal titer higher than 1:64 HR = 8·87 (95% CI 7·70 to 10·22), and children with signs and symptoms at birth HR = 7·10 (95% CI 6·60 to 7·63). Among children registered with CS, CS was recorded as the underlying cause of death in 33% (495/1 496) of neonatal, 11% (85/770) of postneonatal, and 2·9% (6/210) of children 1 year of age. The main limitations of this study were the use of a secondary database without additional clinical information and the potential misclassification of exposure status. Conclusions This study showed an increased mortality risk among children with CS that goes beyond the first year of life. It also reinforces the importance of maternal treatment that infant non-treponemal titers and the presence of signs and symptoms of CS at birth are strongly associated with subsequent mortality. Trial registration Observational study.
Assessment of Nonalcoholic Fatty Liver Disease Symptoms and Gut–Liver Axis Status in Zebrafish after Exposure to Polystyrene Microplastics and Oxytetracycline, Alone and in Combination
Authors: Weishang Zhou, Wei Shi, Xueying Du, Yu Han, Yu Tang, Sanghyok Ri, Kwangjin Ju, Tongchol Kim, Lin Huang, Weixia Zhang, Yihan Yu, Dandan Tian, Yingying Yu, Liangbiao Chen, Zhichao Wu, Guangxu Liu
Journal: Environmental Health Perspectives (2023)

Background: Environmental pollution may give rise to the incidence and progression of nonalcoholic fatty liver disease (NAFLD), the most common cause for chronic severe liver lesions. Although knowledge of NAFLD pathogenesis is particularly important for the development of effective prevention, the relationship between NAFLD occurrence and exposure to emerging pollutants, such as microplastics (MPs) and antibiotic residues, awaits assessment. Objectives: This study aimed to evaluate the toxicity of MPs and antibiotic residues related to NAFLD occurrence using the zebrafish model species. Methods: Taking common polystyrene MPs and oxytetracycline (OTC) as representatives, typical NAFLD symptoms, including lipid accumulation, liver inflammation, and hepatic oxidative stress, were screened after 28-d exposure to environmentally realistic concentrations of MPs (0.69mg/L) and antibiotic residue (3.00μg/L). The impacts of MPs and OTC on gut health, the gut–liver axis, and hepatic lipid metabolism were also investigated to reveal potential affecting mechanisms underpinning the NAFLD symptoms observed. Results: Compared with the control fish, zebrafish exposed to MPs and OTC exhibited significantly higher levels of lipid accumulation, triglycerides, and cholesterol contents, as well as inflammation, in conjunction with oxidative stress in their livers. In addition, a markedly smaller proportion of Proteobacteria and higher ratios of Firmicutes/Bacteroidetes were detected by microbiome analysis of gut contents in treated samples. After the exposures, the zebrafish also experienced intestinal oxidative injury and yielded significantly fewer numbers of goblet cells. Markedly higher levels of the intestinal bacteria-sourced endotoxin lipopolysaccharide (LPS) were also detected in serum. Animals treated with MPs and OTC exhibited higher expression levels of LPS binding receptor (LBP) and downstream inflammation-related genes while also exhibiting lower activity and gene expression of lipase. Furthermore, MP-OTC coexposure generally exerted more severe effects compared with single MP or OTC exposure. Discussion: Our results suggested that exposure to MPs and OTC may disrupt the gut–liver axis and be associated with NAFLD occurrence. https://doi.org/10.1289/EHP11600
The impact of patient safety incidents during hip and knee replacements on patients’ health related quality of life: a before and after study using longitudinal data linked to patient-reported outcome measures
Authors: Mimi Xiao, Søren Rud Kristensen, Joachim Marti, Elias Mossialos
Journal: International Journal of Surgery (2023)

The burden of patient safety incidents (PSIs) is often characterized by their impact on mortality, morbidity, and treatment costs. Few studies have attempted to estimate the impact of PSIs on patients' health-related quality of life (HRQoL) and the studies that have made such estimates primarily focus on a narrow set of incidents. The aim of this paper is to estimate the impact of PSIs on HRQoL of patients undergoing elective hip and knee surgery in England.A unique linked longitudinal data set consisting of patient-reported outcome measures for patients with hip and knee replacements linked to Hospital Episode Statistics (HES) collected between 2013/14 and 2016/17 was examined. Patients with any of nine US Agency for Healthcare Research and Quality (AHRQ) PSI indicators were identified. HRQoL was measured using the general EuroQol five dimensions questionnaire (EQ-5D) before and after surgery. Exploiting the longitudinal structure of the data, exact matching was combined with difference in differences to estimate the impact of experiencing a PSI on HRQoL and its individual dimensions, comparing HRQoL improvements after surgery in similar patients with and without a PSI in a retrospective cohort study. This design compares the change in HRQoL before and after surgery in patients who experience a PSI to those who do not.The sample comprised 190 697 and 204 649 observations for patients undergoing hip replacement and knee replacement respectively. For six out of nine PSIs, patients who experienced a PSI reported improvements in HRQoL that were 14-23% lower than those who did not experience a PSI during surgery. Those who experienced a PSI were also more likely to report worse health states after surgery than those without a PSI on all five dimensions of HRQoL.PSIs are associated with a substantial negative impact on patients' HRQoL.
Group A Streptococcal Meningitis With the M1<sub>UK</sub> Variant in the Netherlands
Authors: Boas C. L. van der Putten, Bart J. M. Vlaminckx, Brechje de Gier, Wieke Freudenburg-de Graaf, Nina M. van Sorge
Journal: JAMA (2023)

This study reports an epidemiological assessment of laboratory-confirmed group A streptococcal meningitis cases in the Netherlands using more than 40 years of national bacteriological surveillance data.
Clinical Images: Hard palate mass as an <scp>IgG4</scp>‐related disease
Authors: Hirotaka Yamamoto, Yoshinori Taniguchi
Journal: Arthritis & Rheumatology (2023)

Disclosure Form Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Design of well-matched end-structure of anatomical proximal femoral locking plate based on computer-assisted imaging combined with 3D printing technology: a quality improvement study
Authors: Xiaoyang Jia, Kun Zhang, Minfei Qiang, Qinghui Han, Guojun Zhao, Ying Wu, Yanxi Chen
Journal: International Journal of Surgery (2023)

The extramedullary locking plate system was the common internal fixation method for hip fractures. However, common plates were poorly matched to femur, which was because they were designed based on anatomical parameters of the Western populations. Therefore, the aim was to design an end-structure of the anatomical proximal femoral locking plate that closely matched the anatomy of the Chinese population.From January 2010 to December 2021, consecutive patients aged 18 years and older who underwent a full-length computed tomography scan of the femur were included. The end-structure (male and female model) of the anatomical proximal femoral locking plate was designed based on anatomical parameters of femurs that were measured in three-dimensional space using computer-assisted virtual technology. The match degree between the end-structure and femur were evaluated. Inter-observer and intra-observer agreement for the evaluation of match degree was assessed. The matching evaluation based on a three-dimensional printing model was regarded as the gold standard to assess the reliability.A total of 1672 patients were included, with 701 men and 971 women. Significant differences were seen between male and female for all parameters of the proximal femur (all P <0.001). All match degree of end-structure was over 90%. Inter-observer and intra-observer agreement was almost perfect (all kappa value, >0.81). The sensitivity, specificity, and percentage of correct interpretation of matching evaluation in the computer-assisted virtual model was all greater than 95%. From femur reconstruction to completion of internal fixation matching, the process takes about 3 min. Moreover, reconstruction, measurement, and matching were all completed in one system.The results showed that based on the larger sample of femoral anatomical parameters, a highly matching end-structure of anatomical proximal femoral locking plate for Chinese population could be designed with use of computer-assisted imaging technology.
Age-related alterations in meningeal immunity drive impaired CNS lymphatic drainage
Authors: Justin Rustenhoven, Georgios Pavlou, Steffen E. Storck, Taitea Dykstra, Siling Du, Zhengpeng Wan, Daniel Quintero, Joshua P. Scallan, Igor Smirnov, Roger D. Kamm, Jonathan Kipnis
Journal: The Journal of Experimental Medicine (2023)

The meningeal lymphatic network enables the drainage of cerebrospinal fluid (CSF) and facilitates the removal of central nervous system (CNS) waste. During aging and in Alzheimer’s disease, impaired meningeal lymphatic drainage promotes the buildup of toxic misfolded proteins in the CNS. Reversing this age-related dysfunction represents a promising strategy to augment CNS waste clearance; however, the mechanisms underlying this decline remain elusive. Here, we demonstrate that age-related alterations in meningeal immunity underlie this lymphatic impairment. Single-cell RNA sequencing of meningeal lymphatic endothelial cells from aged mice revealed their response to IFNγ, which was increased in the aged meninges due to T cell accumulation. Chronic elevation of meningeal IFNγ in young mice via AAV-mediated overexpression attenuated CSF drainage—comparable to the deficits observed in aged mice. Therapeutically, IFNγ neutralization alleviated age-related impairments in meningeal lymphatic function. These data suggest manipulation of meningeal immunity as a viable approach to normalize CSF drainage and alleviate the neurological deficits associated with impaired waste removal.
Cardiovascular Outcomes and Mortality After Bariatric Surgery in Patients With Nonalcoholic Fatty Liver Disease and Obesity
Authors: Arunkumar Krishnan, Yousaf Hadi, Saleh A. Alqahtani, Tinsay A. Woreta, Wei Fang, Salim Abunnaja, Nova Szoka, Lawrence E. Tabone, Shyam Thakkar, Shailendra Singh
Journal: JAMA Network Open (2023)

Importance Bariatric surgery (BS) is associated with significantly reduced incidence of cardiovascular diseases and mortality in patients with obesity. However, whether BS can decrease major adverse cardiovascular events in patients with nonalcoholic fatty liver disease (NAFLD) remains poorly understood. Objective To investigate the association of BS with the incidence of adverse cardiovascular events and all-cause mortality in patients with NAFLD and obesity. Design, Setting, and Participants This was a large, population-based, retrospective cohort using data from the TriNetX platform. Adult patients with a body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) of 35 or greater and NAFLD (without cirrhosis) who underwent BS between January 1, 2005, and December 31, 2021, were included. Patients in the BS group were matched with patients who did not undergo surgery (non-BS group) according to age, demographics, comorbidities, and medication by using 1:1 propensity matching. Patient follow-up ended on August 31, 2022, and data were analyzed in September 2022. Exposures Bariatric surgery vs nonsurgical care. Main Outcomes and Measures The primary outcomes were defined as the first incidence of new-onset heart failure (HF), composite cardiovascular events (unstable angina, myocardial infarction, or revascularization, including percutaneous coronary intervention or coronary artery bypass graft), composite cerebrovascular disease (ischemic or hemorrhagic stroke, cerebral infarction, transient ischemic attack, carotid intervention, or surgery), and a composite of coronary artery procedures or surgeries (coronary stenting, percutaneous coronary intervention, or coronary artery bypass). Cox proportional hazards models were used to estimate hazard ratios (HRs). Results Of 152 394 eligible adults, 4693 individuals underwent BS; 4687 patients who underwent BS (mean [SD] age, 44.8 [11.6] years; 3822 [81.5%] female) were matched with 4687 individuals (mean [SD] age, 44.7 [13.2] years; 3883 [82.8%] years) who did not undergo BS. The BS group had significantly lower risk of new-onset of HF (HR, 0.60; 95% CI, 0.51-0.70), cardiovascular events (HR, 0.53; 95% CI, 0.44-0.65), cerebrovascular events (HR, 0.59; 95% CI, 0.51-0.69), and coronary artery interventions (HR, 0.47; 95% CI, 0.35-0.63) compared with the non-BS group. Similarly, all-cause mortality was substantially lower in the BS group (HR, 0.56; 95% CI, 0.42-0.74). These outcomes were consistent at follow-up duration of 1, 3, 5, and 7 years. Conclusions and Relevance These findings suggest that BS was significantly associated with lower risk of major adverse cardiovascular events and all-cause mortality in patients with NAFLD and obesity.
Patient decision support interventions for candidates considering elective surgeries: a systematic review and meta-analysis
Authors: Ling Jie Cheng, Nick Bansback, Meixia Liao, Vivien Xi Wu, Wenru Wang, Gabriel Ka Po Liu, Hwee Weng Dennis Hey, Nan Luo
Journal: International Journal of Surgery (2023)

Background: The increase in elective surgeries and varied postoperative patient outcomes has boosted the use of patient decision support interventions (PDSIs). However, evidence on the effectiveness of PDSIs are not updated. This systematic review aims to summarize the effects of PDSIs for surgical candidates considering elective surgeries and to identify their moderators with an emphasis on the type of targeted surgery. Design: Systematic review and meta-analysis. Methods: We searched eight electronic databases for randomized controlled trials evaluating PDSIs among elective surgical candidates. We documented the effects on invasive treatment choice, decision-making–related outcomes, patient-reported outcomes, and healthcare resource use. The Cochrane Risk of Bias Tool version 2 and Grading of Recommendations, Assessment, Development, and Evaluations were adopted to rate the risk of bias of individual trials and certainty of evidence, respectively. STATA 16 software was used to conduct the meta-analysis. Results: Fifty-eight trials comprising 14 981 adults from 11 countries were included. Overall, PDSIs had no effect on invasive treatment choice (risk ratio=0.97; 95% CI: 0.90, 1.04), consultation time (mean difference=0.04 min; 95% CI: −0.17, 0.24), or patient-reported outcomes, but had a beneficial effect on decisional conflict (Hedges’ g =−0.29; 95% CI: −0.41, −0.16), disease and treatment knowledge (Hedges’ g =0.32; 95% CI: 0.15, 0.49), decision-making preparedness (Hedges’ g =0.22; 95% CI: 0.09, 0.34), and decision quality (risk ratio=1.98; 95% CI: 1.15, 3.39). Treatment choice varied with surgery type and self-guided PDSIs had a greater effect on disease and treatment knowledge enhancement than clinician-delivered PDSIs. Conclusions: This review has demonstrated that PDSIs targeting individuals considering elective surgeries had benefited their decision-making by reducing decisional conflict and increasing disease and treatment knowledge, decision-making preparedness, and decision quality. These findings may be used to guide the development and evaluation of new PDSIs for elective surgical care.
Efficacy of peripheral electrical nerve stimulation on improvements of urodynamics and voiding diary in patients with neurogenic lower urinary tract dysfunction: a systematic review and meta-analysis
Authors: Qingyu Ge, Hewei Xu, Zongyao Fan, Weilong Li, Zhengsen Chen, Dezhou Yue, Jie Xu, Sicong Zhang, Jun Xue, Baixin Shen, Zhongqing Wei
Journal: International Journal of Surgery (2023)

Peripheral electrical nerve stimulation is a routinely recommended treatment for non-neurogenic overactive bladder but has not been approved for patients with neurogenic lower urinary tract dysfunction (NLUTD). This systematic review and meta-analysis was to elucidate the efficacy and safety of electrostimulation and thus provide firm evidence for treating NLUTD.
Low intra-abdominal pressure in laparoscopic surgery: a systematic review and meta-analysis
Authors: Gabby T.J.A. Reijnders-Boerboom, Kim I. Albers, Lotte M.C. Jacobs, Esmee van Helden, Camiel Rosman, Oscar Díaz-Cambronero, Guido Mazzinari, Gert-Jan Scheffer, Christiaan Keijzer, Michiel C. Warlé
Journal: International Journal of Surgery (2023)

Background: Guidelines do not provide clear recommendations with regard to the use of low intra-abdominal pressure (IAP) during laparoscopic surgery. The aim of this meta-analysis is to assess the influence of low versus standard IAP during laparoscopic surgery on the key-outcomes in perioperative medicine as defined by the StEP-COMPAC consensus group. Materials and methods: We searched the Cochrane Library, PubMed, and EMBASE for randomized controlled trials comparing low IAP (&lt;10 mmHg) with standard IAP (10 mmHg or higher) during laparoscopic surgery without time, language, or blinding restrictions. According to the PRISMA guidelines, two review authors independently identified trials and extracted data. Risk ratio (RR), and mean difference (MD), with 95% CIs were calculated using random-effects models with RevMan5. Main outcomes were based on StEP-COMPAC recommendations, and included postoperative complications, postoperative pain, postoperative nausea and vomiting (PONV) scores, and length of hospital stay. Results: Eighty-five studies in a wide range of laparoscopic procedures (7349 patients) were included in this meta-analysis. The available evidence indicates that the use of low IAP (&lt;10 mmHg) leads to a lower incidence of mild (Clavien–Dindo grade 1–2) postoperative complications (RR=0.68, 95% CI: 0.53–0.86), lower pain scores (MD=−0.68, 95% CI: −0.82 to 0.54) and PONV incidence (RR=0.67, 95% CI: 0.51–0.88), and a reduced length of hospital stay (MD=−0.29, 95% CI: −0.46 to 0.11). Low IAP did not increase the risk of intraoperative complications (RR=1.15, 95% CI: 0.77–1.73). Conclusions: Given the established safety and the reduced incidence of mild postoperative complications, lower pain scores, reduced incidence of PONV, and shorter length of stay, the available evidence supports a moderate to strong recommendation (1a level of evidence) in favor of low IAP during laparoscopic surgery.
Comment on ‘Does bariatric surgery really benefit patients before total knee arthroplasty? a systematic review and meta-analysis’
Authors: Xing Chen
Journal: International Journal of Surgery (2023)

Department of Orthopaedics and Traumatology, YiWu Central Hospital, Zhejiang 322000, China Running Title: bariatric surgery and total knee arthroplasty. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding Author. Address: Xing Chen, MM, Department of Orthopaedics and Traumatology, YiWu Central Hospital, Zhejiang 322000, China. E-mail address: [email protected]. (X. Chen). This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/
In vitro supporting diagnostic tools in plant‐food allergy
Authors: José Antonio Céspedes, Clara Lebrón‐Martín, Reyes García‐Otón, María Jesús Delgado, María del Carmen Martín‐Astorga, Natalia Pérez‐Sánchez, Francisca Gómez, María José Torres, José Antonio Cañas, Carlos José Aranda, Cristobalina Mayorga
Journal: Allergy (2023)

Figure S1 Gate selection strategy used in BAT and MAT. (A) Flow gating strategy used in BAT. Basophils were selected as SSC-Alow/CCR3+/CD203c+. (B) Representative plots of activated basophils selected as CD63+. (C) Gating strategy used in MAT. (D) Activated LAD2 cells were selected as CD63+. In both cases, representative figures of negative and positive degranulation after allergen stimulation are shown. Figure S2 ROC curve parameters of %CD63+ for MAT and BAT, and sIgE. ****p < 0.0001. BAT, basophil activation test; MAT, mast cells activation test; NPV, negative predictive value; PPV, positive predictive value. Figure S3 Scatterplots showing spearman correlations between tIgE, sIgE to Pru p 3, SPT area and %CD63+ cells in BAT and MAT. Table S1 Individual clinical characteristics and allergological work-up results. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Trends in Medicare Spending on Oral Drugs for Chronic Lymphocytic Leukemia From 2014 to 2020
Authors: Edward R. Scheffer Cliff, Aaron S. Kesselheim, Benjamin N. Rome, William B. Feldman
Journal: JAMA Network Open (2023)

This cross-sectional study analyzes trends in Medicare Part D use and spending on oral-targeted drugs for chronic lymphocytic leukemia from 2014 to 2020.